Questionable necessity to remove the submandibular gland in neck dissection

Takes, Robert P.; Robbins, K. Thomas; Woolgar, Julia A.; Rinaldo, Alessandra; Silver, Carl E.; Olofsson, Jan; Ferlito, Alfio

doi:10.1002/hed.21451

Cited by 23 publications

(16 citation statements)

References 80 publications

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“…Several prior reports have suggested the safety of submandibular gland preservation during treatment of head and neck carcinoma, citing the low prevalence of submandibular gland involvement by carcinoma. 5,9 In our study, submandibular gland preservation during treatment of oropharyngeal squamous cell carcinoma was confirmed to be an oncologically sound technique that resulted in no change in disease free survival, disease specific survival, or overall survival compared to gland removal. This is further supported by prior literature reports suggesting that treatment of level 1 during neck dissection for oropharyngeal carcinoma may be unnecessary in the absence of clinical disease.…”

Section: Discussionsupporting

confidence: 57%

Submandibular Gland Preservation during Concurrent Neck Dissection and Transoral Surgery for Oropharyngeal Squamous Cell Carcinoma

Howard

Hinni

Nagel

et al. 2014

Otolaryngol.--head neck surg.

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Section: Discussionsupporting

confidence: 57%

Submandibular Gland Preservation during Concurrent Neck Dissection and Transoral Surgery for Oropharyngeal Squamous Cell Carcinoma

Howard

Hinni

Nagel

et al. 2014

Otolaryngol.--head neck surg.

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“…Similar studies have reported metastasis to submandibular gland from an index tumor in head and neck is either very rare or never found [13][14][15][16]. Fibrous capsule surrounding the submandibular gland provides an effective barrier to the spread of squamous cell carcinoma, even when the gland is compressed by bulky metastatic disease [17].…”

Section: Discussionmentioning

confidence: 84%

Questionable Necessity for Removing Submandibular Gland in Neck Dissection in Squamous Cell Carcinoma of Oral Cavity

Agarwal

Nagpure

Chavan

2016

Indian J Otolaryngol Head Neck Surg

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To assess whether submandibular gland is involved by metastasis in cases of oral cavity squamous cell carcinomas. It was a retrospective study, where we reviewed the records of the patients who underwent neck dissections for Squamous Cell Carcinoma of the oral cavity. It included 112 patients who had undergone 115 neck dissections (three patients had undergone bilateral neck dissection), either therapeutic or prophylactic. No pathologic evidence of metastasis to submandibular gland was seen in any of the case. Preservation of submandibular glands can be a good technique for reducing future complications in a patient undergoing Neck Dissection wherever feasible. Therefore, if there is no need to expose large oral cavity tumors through the submandibular triangle, or when there is no direct extension of the primary and/or regional lymph nodes into the submandibular gland, it may be safe to preserve the submandibular gland.

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“…Baş boyun bölgesindeki primer tümörlerin submandibular beze hematojen yayılma oranı da oldukça düşüktür. Patolojik değerlendirmede de submandibular bezi saran fibröz kapsülün primer baş boyun böl-gesi karsinomlarının yayılmasına engel bir bariyer olarak görev aldığı görülmüştür (5) . Boyunda 1. bölgede gizli lenf nodu tutulumu enderdir.…”

Section: Discussionunclassified

Submandibular gland in early stage oral cavity cancer

Bulğurcu¹,

Arslan²,

Demirhan³

et al. 2015

Terh

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ÖZETAmaç: Çalışmamızda boyun 1b bölgesinde yer alan submandibular bezin erken evre oral kavite kanserlerinde eksizyonunun gerekliliğini araştırmayı planladık. Yöntemler: Çalışmaya kliniğimizde Nisan 2008 ile Eylül 2014 tarihleri arasında erken evre oral kavite kanseri nedeniyle opere edilen 12 olgu dâhil edildi. Olguların tanı anındaki hastalık evreleri, boyundaki metastatik lenf nodu sayıları ve submandibular bez tutulumu preoperatif radyolojik incelemelere ve patoloji sonuçlarına göre değerlendirildi. Bulgular: Çalışmaya dahil edilen olguların yaş aralığı 48 ile 75 yıl arasında değişmekte ve olgular 3 kadın ve 9 erkekten oluşmaktaydı. Altı olgu dil kanseri nedeniyle opere edilirken, 4 olgu dudak, 1 olgu ağız tabanı ve 1 olgu da retromolar bölge karsinomu nedeniyle operasyona alınmıştı. Operasyon sonrası patoloji raporlarında olguların 4'ünde boyun lenf nodu diseksiyonlarında lenf nodu metastazı saptandığı görüldü. Olguların tümünde eksize edilen submandibular bezin salim olarak yorumlandığı dikkati çekti. Sonuç: Bu çalışmada erken evre oral kavite karsinomlu olguların çıkarılan submandibuler bezlerinde histopatolojik olarak malignite saptanmadı. Olgu sayısının ve submandibular bezden alınan kesit sayısının artırıldığı çalışmalarla elde edilen sonucun doğrulanması gerektiği düşüncesindeyiz.Anahtar kelimeler: Submandibular bez, oral kavite kanseri, metastaz ABSTRACT Objective: We planned in our study to search the need for excision of submandibular gland localized in the neck 1b area, in early stage oral cavity cancers. Methods: In our clinic, 12 patients who had undergone operation with the diagnosis of early stage oropharyngeal cancer were included in this study. We described the stage of the disease, lymph node metastases status and invasion of submandibular salivary gland based on preoperative radiological examination and pathological results. Results: Patients (3 female, and 9 male patients) aged between 48 to 75 years were included in the study. Patients were operated with the diagnosis of cancer of tongue (n=6), lip cancer (n=4), floor of the mouth cavity (n=1), and cancer of the retromolar region (n=1). Metastases of cervical lymph nodes were deteched in postoperative pathology reports of 4 patients. Submandibular salivary gland was histopathologically normally in all cases. Conclusion: In this study, histopathological report of excised submandibular gland in patients with the early stages of the oral cavity carcinoma could not detect any malignancy. We believe that this result should be confirmed by studies with increased number of cases and pathological sections from the salivary gland.

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Questionable necessity to remove the submandibular gland in neck dissection

Cited by 23 publications

References 80 publications

Submandibular Gland Preservation during Concurrent Neck Dissection and Transoral Surgery for Oropharyngeal Squamous Cell Carcinoma

Submandibular Gland Preservation during Concurrent Neck Dissection and Transoral Surgery for Oropharyngeal Squamous Cell Carcinoma

Questionable Necessity for Removing Submandibular Gland in Neck Dissection in Squamous Cell Carcinoma of Oral Cavity

Submandibular gland in early stage oral cavity cancer

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